Gliederung

Background: Breast cancer survivors experience adverse effects of cancer and/or treatment years after completion of therapy, which can considerably decrease quality of life (QoL). Due to the small number of longitudinal studies, with follow-up times mostly below or up to five years, knowledge on the time course of QoL is very limited. Given the increasing number of long-term survivors, we explored in detail the time course of QoL over a 10-year period in breast cancer survivors.

Methods: Health-related QoL was assessed 1, 3, 5, and 10 years after diagnosis in a population-based cohort of 370 breast cancer patients from Saarland (Germany), using the EORTC QLQ-C30 questionnaire and the tumor specific module QLQ-BR23. The time course of QoL over a 10-year period post-diagnosis was compared to controls from the general population of Germany, controlling for age.

Results: 182 patients (81% of all patients alive) responded in the 10-year, 160 patients (71%) participated in all follow-ups. Ten years post-diagnosis, all QoL dimensions, except global QoL, were worse in survivors than controls. Over the entire time span of 10 years post-diagnosis, survivors reported more restrictions in role, emotional, cognitive, and social functioning and had higher scores for fatigue, dyspnea, insomnia, constipation, diarrhea, and financial difficulties. For emotional, cognitive and social functioning, nausea/vomiting, pain, dyspnea, constipation, diarrhea and financial difficulties, differences strengthened from 5 to 10 years. Generally, restrictions were largest for the youngest survivors (age at diagnosis < 50 years).

Conclusion: Even 10 years after diagnosis, breast cancer survivors reported clinically meaningful restrictions in QoL. Some differences between survivors and controls even strengthened from 5 to 10 years. As compared to older patients, restrictions in QoL were largest for the youngest age group.